Tobian L, Johnson M A, Lange J, Magraw S
Circ Res. 1975 Jun;36(6 Suppl 1):162-70. doi: 10.1161/01.res.36.6.162.
Isolated kidneys from both "post-salt" normotensive and hypertensive rats were perfused with blood from donor rats at varying pressures. At 130 mm Hg inflow pressure 15 "post-salt normotensive" kidneys put out 0.75 muEq Na/min/g kidney while 14 "post-salt hypertensive" kidneys put out 0.28 mu-Eq Na/min/g (P less than 0.001), a 63% reduction. They also put out 55% less water (P less than 0.002). Thus, if "hypertensive" kidneys are perfused at normal pressures, they put out subnormal amounts of Na and H-2-O. Such Na and H-2-O retention maintains the hypertensive state. Normal Na output in these kidneys was only reached at hypertensive (160) inflow pressures. This shift in the "pressure natriuresis" curve explains in part how some "hypertensive" kidneys maintain hypertension. These "hypertensive" kidneys have grossly abnormal autoregulation curves, each increment of pressure actually producing progressively greater increments of blood flow. Isolated kidneys from Kyoto hypertensive and normotensive rats showed no difference in Na and H-2-O excretion at 130 mm Hg inflow pressure. Thus, a tendency to Na retention demonstrable in the isolated kidney is apparently not supporting Kyoto hypertension. Moreover, isolated kidneys form Kyoto hypertensive rats released significantly lower amounts of renin at all levels of inflow pressure, averaging a 70% lower rate than Kyoto normotensive kidneys (P less than 0.01). Hence, Kyoto hypertension is not supported by a supernormal renin release inherent in the kidney. One can speculate that Kyoto hypertensive rats normally have an elevated sympathetic tone which stimulates release of renin. The denervation which occurs in isolating kidneys might therefore produce a proportionally greater percentage loss of sympathetic influence in these kidneys, which could possibly account for some of their reduced renin release. These Kyoto hypertensive kidneys are apparently not "reset" to maintain hypertension with either Na or renin.
分别用供体大鼠的血液在不同压力下灌注“盐负荷后”正常血压和高血压大鼠的离体肾脏。在130 mmHg的流入压力下,15个“盐负荷后正常血压”肾脏每分钟每克肾脏排出0.75微当量钠,而14个“盐负荷后高血压”肾脏每分钟每克排出0.28微当量钠(P<0.001),减少了63%。它们排出的水也减少了55%(P<0.002)。因此,如果以正常压力灌注“高血压”肾脏,它们排出的钠和水低于正常水平。这种钠和水的潴留维持了高血压状态。这些肾脏只有在高血压(160)流入压力下才达到正常的钠排出量。“压力利尿”曲线的这种偏移部分解释了一些“高血压”肾脏如何维持高血压。这些“高血压”肾脏的自动调节曲线明显异常,压力的每一次增加实际上都会使血流量逐渐增加得更多。京都高血压和正常血压大鼠的离体肾脏在130 mmHg流入压力下的钠和水排泄没有差异。因此,离体肾脏中可证实的钠潴留倾向显然不支持京都高血压。此外,京都高血压大鼠的离体肾脏在所有流入压力水平下释放的肾素量都显著较低,平均比京都正常血压肾脏低70%(P<0.01)。因此,京都高血压不是由肾脏固有的超常肾素释放所支持的。可以推测,京都高血压大鼠通常交感神经张力升高,刺激肾素释放。因此,在分离肾脏时发生的去神经支配可能会使这些肾脏中交感神经影响的损失比例更大,这可能是它们肾素释放减少的部分原因。这些京都高血压肾脏显然没有通过钠或肾素来“重置”以维持高血压。